Various surgical procedures are routinely carried out intravascularly or intraluminally. For example, in the treatment of vascular disease, such as arteriosclerosis, it is a common practice to invade the artery and insert an instrument (e.g., a balloon or other type of catheter) to carry out a procedure within the artery. Such procedures usually involve the percutaneous puncture of the artery so that an insertion sheath can be placed in the artery. The insertion sheath enables the introduction of other instruments (e.g., a catheter) to an operative position within the vascular system.
Intravascular and intraluminal procedures often include instruments of certain dimensions that must be precisely located with respect to the percutaneous puncture. The relative position of the various instruments with respect to the puncture in the artery must be known by an operator in order to properly conduct the intravascular procedure.
However, intravascular and intraluminal procedures unavoidably present the problem of stopping the bleeding at the percutaneous puncture after the procedure has been completed and after the instruments (and any insertion sheaths used therewith) have been removed. Bleeding from puncture sites, particularly in the case of femoral arterial punctures, is typically stopped by utilizing vascular closure devices, such as those described in U.S. Pat. Nos. 6,179,863; 6,090,130; and 6,045,569, which are hereby incorporated by this reference. Typical closure devices such as the ones described in the above-mentioned patents place a sealing plug at the tissue puncture site. However, the closure devices must be in a proper position relative to the puncture in order to place the sealing plug. If the location of the puncture relative to the closure device is not precisely known, the sealing plug may not be placed at a location conducive to effecting hemostasis of the puncture.
Typically, location of the puncture within an artery is determined by inserting the closure device and/or an insertion sheath into the artery until blood enters a lumen in the closure device or insertion sheath. As blood exits the lumen through a drip hole in the closure device or insertion sheath, the operator has visual indication of the location of the closure device. The insertion sheath and/or the closure device may then be retracted a certain distance indicated by markings on the insertion sheath to properly locate the closure device relative to the puncture. However, it is sometimes difficult and time consuming for some operators to find the exact location such that blood just begins to flow through a locating lumen, and it can also be inconvenient to monitor the markings on the insertion sheath and retract the closure device and insertion sheath a precise, prescribed distance. Accordingly, it would be helpful to improve the locating method and mechanism such that location could be determined by a positive stop transmitted to an operator by tactile feedback.